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Abstract Aim First grade is a transition from pre‐school to school‐age. The change in lifestyle behaviours such as sleep may have a physiological response, which contributes to the presence or absence of two highly incident diseases: dental caries or myopia. The aim of the study was to examine the association between sleep and myopia as well as sleep and dental caries in first graders. Design It is a cross‐sectional study. Methods This was a recruitment phase of an interventional study. A total of 338 children whose caregivers completed a Children's Sleep Habits Questionnaire. Caregivers also provided information regarding myopia and caries status of children and their parents. Binary logistic regression was applied to analyse the potential risk factors. Results Dental caries and myopia rates were 45.9% and 9.5%, respectively. After adjusting for children's gender, children's age, fathers with caries and mothers with caries, the odds ratio for dental caries in children who slept less than 9 h when compared to those who slept for nine and more hours was 1.94. Mothers with caries were 3.37 times more likely to have children with caries than mothers without caries. However, sleep was not associated with myopia in first graders. Conclusion Sleeping less than 9 h and maternal caries were risk factors of children developing dental caries. Future sleep and myopia studies can be conducted on higher graders who may present prolonged exposure and accumulations of myopic risk factors. Implications Screening of children with insufficient sleep is needed for nurses to enable the early identification of high‐risk groups for dental caries in school settings. Family nurses are encouraged to work with family members to implement tailored sleep interventions, in order to facilitate better sleep and oral health practices in both school and home settings. Registration This study protocol was registered on ClinicalTrials.gov (Registration number: Redacted).

BackgroundWhile the challenges of COVID-19 are still unfolding, the enhancement of protective behavior remains a top priority in global health care. However, current behavior-promoting strategies may be inefficient without first identifying the individuals with lower engagement in protective behavior and the associating factors. ObjectiveThis study aimed to identify individuals with and potential contributing factors to low engagement in protective behavior during the COVID-19 pandemic. MethodsThis is a causal-comparative study. A theory-based web-based survey was used to investigate individuals’ protective behavior and potential associating factors. During June 2020, the distribution of the survey was targeted to 3 areas: Taiwan, Japan, and North America. Based on the theory of the health belief model (HBM), the survey collected participants’ various perceptions toward COVID-19 and a collection of protective behaviors. In addition to the descriptive analysis, cluster analysis, ANOVA, and Fisher exact and chi-square tests were used. ResultsA total of 384 responses were analyzed. More than half of the respondents lived in Taiwan, followed by Japan, then North America. The respondents were grouped into 3 clusters according to their engagement level in all protective behaviors. These 3 clusters were significantly different from each other in terms of the participants’ sex, residency, perceived barriers, self-efficacy, and cues of action. ConclusionsThis study used an HBM-based questionnaire to assess protective behaviors against COVID-19 and the associated factors across multiple countries. The findings indicate significant differences in various HBM concepts among individuals with varying levels of behavioral engagement.

Extracranial and meningeal seeding of glioblastoma multiforme is rare. We report herein a case of glioblastoma in a 41-year-old man who underwent surgical resection, concomitant chemoradiotherapy (CCRT) and seven courses of adjuvant chemotherapy with temozolomide. The patient then complained of intermittent severe lower back pain and gait disturbance. Imaging studies demonstrated that although the intracranial residual tumors were well-controlled by the treatment, meningeal seeding involving the brainstem and spinal cord was present. The patient died 2 months after the diagnosis of spinal seeding. This case illustrates the need for consideration of extracranial metastasis if a patient is symptomatic, even if the intracranial tumor appears responsive to treatment. We suggested that the prophylactic craniospinal irradiation may be considered in patients at high risk of meningeal seeding immediately after surgery.

The aim of the present study was to identify genetic and epigenetic alterations involved in the progression of oligodendroglial tumors. We characterized 21 paired, World Health Organization (WHO) grade II and III oligodendroglial tumors from patients who received craniotomies for the partial or complete resection of primary and secondary oligodendroglial tumors. Tumor DNA was analyzed for alterations in selected genetic loci (1p36, 9p22, 10q23-24, 17p13, 19q13, 22q12), isocitrate dehydrogenase 1 (IDH1), isocitrate dehydrogenase 2 (IDH2) and the CpG island methylation status of critical tumor-related genes (MGMT, P16, DAPK, PTEN, RASSF1A, Rb1). Alterations of these markers were common early in the tumorigenesis. In the primary tumors we identified 12 patients (57.1%) with 1p36 deletions, 17 (81.0%) with 19q13 deletions, 9 (42.9%) with 1p36/19q13 codeletions, 11 (52.3%) with 9p22 deletions, and 12 (57.1%) with IDH1 mutation. Epigenetic analysis detected promoter methylation of the MGMT, P16, DAPK, PTEN, RASSF1A, and Rb1 genes in 38.1%, 19.0%, 38.1%, 33.3%, 66.7%, and 14.3% of primary tumors, respectively. After progression, additional losses of 1p, 9p, 10q, 17p, 19q and 22q were observed in 3 (14.3%), 1 (4.8%), 3 (14.3%), 2 (9.5%), 1 (4.8%) and 3 (14.3%) cases, respectively. Additional methylations of the MGMT, P16, DAPK, PTEN, RASSF1A, and RB1 promoters was observed in 4 (19.0%), 2 (9.5%), 0 (0%), 6 (28.6%), 2(9.5%) and 3 (14.3%) cases, respectively. The status of IDH1 mutation remained unchanged in all tumors after progression. The primary tumors of three patients with subsequent progression to high-grade astrocytomas, all had 9p deletion, intact 1p, intact 10q and unmethylated MGMT. Whether this may represent a molecular signature of patients at-risk for the development of aggressive astrocytomas needs further investigation.

An introduction is presented in which the author discusses articles within the issue on topics including effectiveness of cognitive simulation training in people with schizophrenia, use of psychometrically sound instruments by nurse scientists, and an ethnography study that helps nurses and healthcare professionals understand the beliefs and challenges faced by patients with severe mental illness and in managing their diabetic diets.

Background: Fatigue is among the most prevalent and distressing symptoms in pregnant and postpartum women. Estimating fatigue severity with a psychometrically sound instrument provides the most fundamental information for understanding women's fatigue experience and assessing the need for intervention to improve maternal and infant health outcomes. Objectives: To evaluate the psychometric properties of a Chinese version of the 7-item Lee Fatigue Scale-Short Form (C-LFS-SF) in pregnant and postpartum women. Methods: The study was composed of two phases: translation of the scale into Chinese and examination of content validity, and testing to establish the reliability and validity. A convenience sample of 124 women completed health-related questionnaires, kept a fatigue diary and wore a wrist actigraph for 7 days during the third trimester of pregnancy and within three months postpartum. Results: The C-LFS-SF showed satisfactory internal consistency (Cronbach's alpha ≥ .97) and stability over the 7 days at each time point (intraclass correlation coefficient > .87). Exploratory factor analysis showed that 88-94% of the total variance was explained by the one-factor fatigue model. Significant associations among the C-LFS-SF and actigraphic sleep quantity and quality variables supported adequate construct validity. Conclusions: The C-LFS-SF has satisfactory psychometric properties and is an easy and promising tool for assessing maternal fatigue during routine prenatal and postpartum care. This scale needs to be further tested in a more diverse population of pregnant and postpartum women, like women with high risk pregnancies or with medical conditions. [ABSTRACT FROM AUTHOR]

Objective: to describe the aspects of infant sleep perceived as problematic by first-time Taiwanese mothers and to discover how mothers cope in response to infant sleep concerns. Design: a qualitative approach was used for data collection. Setting: in-depth interviews were conducted and audio-taped at mothers' homes. Participants: 12 first-time mothers within three months post partum. Measurement and findings: content analysis was performed to identify patterns, similarities, and differences in the individual and collective interview data. The major themes describing maternal coping experiences were 'self-help' and 'seek-help.' Self-help coping efforts included reception and acceptance of suggestions as well as changing behaviour to allow mothers to feel capable of adapting to infant sleep patterns or problems. Seek-help was a later stage of coping for mothers when they actively utilised formal and informal sources of help to identify and manage infant sleep problems. The majority of mothers sought informal help sources from family members, friends, or online information. Mothers who suspected their infant of suffering from sleep problems either delayed seeking medical advice or did not actively consult a health care provider. Conclusions and implications for practice: nurses and health care providers who work in antenatal, postnatal, and paediatric clinics should actively educate and provide information about infant sleep patterns and sleep management options to first-time mothers and discuss maternal coping strategies. [ABSTRACT FROM AUTHOR]

The article discusses a study aimed at comparing daytime physical activity (PA) levels in children with and without asthma. The relationships among asthma, PA, body mass index (BMI), and child reports of symptoms were also examined. The results show that children with asthma reported more limitations in PA due to breathing problems. Mean, peak and total time spent in moderate plus vigorous PA (MVPA) showed interaction between asthma and BMI. Limitations of the study are also discussed.

Objectives A descriptive pilot study to examine sleep and daytime naps in adolescent girls with chronic musculoskeletal (MSK) pain. Methods Seventeen girls (14.9 ± 2.0 years) completed questionnaires on anxiety and depressive symptoms during their clinic visit, and maintained a sleep diary and wore an actigraph for 7 days. Parents completed a daily diary of their teen's medications and approaches used to ease pain. Results Average nighttime sleep was 7.2 hr by actigraphy. All participants had mean sleep efficiency <90%. In diaries, 76.5% of the girls reported daytime naps; five girls reported more than three days with naps and more naps were associated with lower sleep efficiency and total nighttime sleep. Conclusions Adolescent girls with chronic MSK pain may sleep fewer hours at night than is recommended and nap in the daytime to compensate for insufficient nighttime sleep. [ABSTRACT FROM AUTHOR]